The restoration of gait for stroke survivors, patients with cerebral palsy, and patients with other neurological diseases is often cited as a primary patient goal in rehabilitation. In the early 1980's, a form of therapy intended to restore gait termed body-weight supported treadmill training (BWSTT) was developed. In BWSTT, all or a portion of the patient's body weight is supported while the patient walks on a treadmill, typically with assistance.
One of the benefits of BWSTT is the ability to enable the patient to perform a high number of repetitions of the full gait cycle early in the rehabilitation process. By way of example, patients can perform up to 2,000 steps during a 20 minute BWSTT session. In addition, the ability to adjust variables such as the amount of body-weight support, the speed of the treadmill, and the amount of assistance provided to the patient provides a flexible environment in which the intensity and focus of the treatment session can be tailored to address patient-specific deficits.
Because patients are usually incapable of making active steps on their own early in the rehabilitation cycle, physical therapists typically must manually move patients' feet step-by-step on the treadmill. This requires the physical therapists to bend over for extended periods of time, risking low back discomfort and/or injury. Furthermore, the therapy is physically exhausting to the therapists and most become fatigued after helping patients for only a few minutes. Moreover, two therapists are typically needed in BWSTT because one therapist must move the patient's foot while the other therapist operates the treadmill controls and monitors the patient.
The physical burden placed upon the physical therapist when BWSTT is performed has resulted in underutilization of that therapy. This is unfortunate because BWSTT has been reported to provide significant improvement to patient gait when performed. In an effort to reduce the physical work required by the therapist, several robotic devices have been developed for use in BWSTT that assist the patient in walking. Although such devices do reduce the amount of work for the therapist, they are very expensive and are out of reach for many rehabilitation facilities. Moreover, the robotic devices often “do all the work” for the patient and therefore do not encourage the patient's active involvement in motor learning. The devices also restrict leg and foot movement to a fixed kinematic pattern that may interfere with the active involvement of the patient. Additionally, robotic devices are heavy and act as an additional burden for the patient to overcome in developing their active waking. All of these factors reduce rehabilitation efficacy.
In view of the above discussion, it can be appreciated that it would be desirable to have an alternative system and method for facilitating gait training.